Since the 1970s, psychological research on homosexuality has demonstrated that sexual minorities experience a great deal of hardship and distress from living in a predominantly heterosexist society. This paper provides a review of the literature on internalized heterosexism (IH) and its psychological correlates. It also critically reviews the empirical research on IH as it correlates to sexual identity formation, AOD use and abuse, anxiety, depression, and overall psychological distress. Additional attention is provided to future research directions, in particular, the distinction of shame versus guilt as they pertain to IH. The importance of investigating shame as a potential mediator or moderator of the relationship between IH and psychological/psychosocial outcomes is discussed as well as practical reasons for investigating shame in the sexual minority experience.
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